Ovarian fibroma

　　The etiology of ovarian sex cord stromal tumors is not yet clear. Research has found that abnormalities in the number and structure of chromosomes have been found at the cellular and molecular level; certain oncogenes and tumor suppressor genes have been found to play a role at the molecular level.
　　Ovarian fibroma is mostly unilateral, with bilateral accounting for 4% to 10%. It is round, kidney-shaped, or lobulated nodular. The surface is smooth, the capsule is complete, solid, and hard. The cut surface is solid, with a woven structure, grayish or pinkish white, occasionally with hemorrhage or cystic change. The tumor cells are long spindle-shaped, with little cytoplasm, and no lipid droplets. The cells are arranged closely, showing a woven or wavy pattern. Collagen fibers are abundant, and extensive hyaline change may be present. The tumor cells do not have atypical shapes, nor nuclear division figures.
　　Fibroma (or theca cell tumor, fibrotheca cell tumor) occasionally contains a small amount of sex cord cell components, generally accounting for about 5% of the tumor components. The biological behavior of the clinical manifestations of the tumor is similar to that of fibroma, rather than that of sex cord cell components (granulosa cell tumor or Sertoli cell tumor) tumors, which are called fibroma (or theca cell) containing sex cord components.

　　Ovarian fibroma alone combined with ascites is more common, accounting for about 41%, especially in patients with large tumors and edema in the tumor stroma, the incidence rate is significantly increased. Ascites is very rare in benign ovarian tumors, which is also a characteristic manifestation of ovarian fibroma. Clinical patients may present with abdominal distension, abdominal enlargement, chest tightness, shortness of breath, difficulty in urination, and other symptoms. Ovarian fibroma, due to its solid, hard texture, and certain weight, is prone to torsion when the patient's body position changes. Approximately half of the patients in clinical practice have symptoms of abdominal pain.

　　Patients with ovarian fibroma have mainly four clinical manifestations: pelvic mass, ascites, pleural effusion, abdominal pain, and menstrual disorders.

　　1, Pelvic mass:Although the size of ovarian fibroma varies greatly, most of them are of medium size, with an average diameter of about 10cm. The tumor is generally smooth and active, but it is hard in texture, which is the hardest tumor among all ovarian tumors, and this is an important clinical characteristic.
　　2, Ascites, pleural effusion:Ovarian fibroma combined with pleural effusion and ascites, the disappearance of pleural effusion and ascites after tumor resection is defined as Meige syndrome. However, it is not common in clinical practice. Ovarian fibroma alone combined with ascites is more common, accounting for about 41%, especially in patients with large tumors and edema in the tumor stroma, the incidence rate is significantly increased. Ascites is very rare in benign ovarian tumors, which is also a characteristic manifestation of ovarian fibroma. Clinical patients may present with abdominal distension, abdominal enlargement, chest tightness, shortness of breath, difficulty in urination, and other symptoms.
　　3. Abdominal pain:Due to its solid nature, hardness, and certain weight, ovarian fibroma is prone to torsion when the patient's body position changes. In clinical practice, nearly half of the patients have symptoms of abdominal pain.
　　4. Menstrual disorders:A small number of ovarian fibromas still have endocrine function. Clinically, patients may have menstrual disorders or postmenopausal bleeding.

　　The etiology of ovarian fibroma is not yet clear, so there is no effective preventive measure. Middle-aged and elderly women should have regular physical examinations, strive to achieve early detection and early treatment, and closely follow up after treatment, treating recurrent patients in a timely manner.

　　When middle-aged and elderly women have smooth and active masses in the adnexa, symptoms of endocrine disorders are not obvious, and the tumor texture is hard, it is not difficult to diagnose ovarian fibroma by combining the following examination results.
　　1. Laboratory examination: tumor markers.
　　2. Other auxiliary examinations: abdominal ultrasound, laparoscopy, tissue pathological examination.

　　After surgery, it is necessary to pay close attention to diet. The diet of patients with ovarian fibroma should be light, and they should not eat or eat less high-dose lactose and excessive animal fat. Avoid dietary preferences, and eat more foods rich in fiber, trace elements, and fiber-like foods, such as mushrooms, soybeans, fresh vegetables, winter mushrooms, and turtle, kelp, nori, and oysters, etc.

　　The best treatment method for fibroma is surgical resection, supplemented by radiotherapy and chemotherapy, to achieve the purpose of eradication.
　　1. Fibroma:Ovarian fibroma is a benign tumor. For young women, if the contralateral ovary is explored normally, adnexectomy on the affected side can be performed. For middle-aged and elderly women, total hysterectomy with bilateral adnexectomy can be performed. For patients with pleural effusion and ascites, pleural effusion and ascites naturally regress after surgery.
　　2. Cellular fibroma:It belongs to a low-grade malignant potential tumor. It is recommended that patients undergo total hysterectomy with bilateral adnexectomy. For young women who have not given birth, if the contralateral ovary is explored normally and there are no signs of metastasis, the affected side adnexectomy can be performed, but close follow-up is required. Patients with signs of recurrence should be treated as soon as possible.
　　3. Fibrosarcoma:The degree of malignancy is extremely high, and radical oophorectomy should be performed, followed by chemotherapy or radiotherapy after surgery.